Comparing robotic and endo-laparoscopic methods for difficult gallstone removal

Randomized Trial Comparing One-stage Robotic Approach Versus Two-stage Endo-laparoscopic Approach for Difficult Choledocholithiasis (REAL Trial)

Not applicable Interventional Chinese University of Hong Kong · NCT05611840

This study is testing whether robotic surgery or endo-laparoscopic surgery works better for people with stubborn gallstones that haven't improved with regular treatments.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment90 (estimated)
SexAll
SponsorChinese University of Hong Kong Academic / other
Locations1 site (Hong Kong)
Trial IDNCT05611840 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of robotic surgery versus endo-laparoscopic surgery in treating difficult choledocholithiasis, a condition where gallstones obstruct the common bile duct. The study involves patients who have not responded to standard endoscopic treatments and aims to determine which surgical approach yields better outcomes. Participants will undergo either robotic or endo-laparoscopic procedures, with their recovery and success rates monitored and compared. The trial is designed to provide clearer guidance on the best surgical options for patients facing this challenging condition.

Who should consider this trial

Good fit: Ideal candidates for this study are adults diagnosed with difficult choledocholithiasis who have not undergone cholecystectomy and are fit for general anesthesia.

Not a fit: Patients with a history of recurrent pyogenic cholangitis or those who have experienced complications from previous ERCP procedures may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved surgical outcomes and recovery for patients with difficult choledocholithiasis.

How similar studies have performed: Previous studies have shown mixed results regarding the effectiveness of surgical versus endoscopic approaches for choledocholithiasis, making this trial's comparative analysis particularly relevant.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Definitions of difficult CBD stone: stone size \> 1.5cm, and/or multiple stones \> 3, and/or narrow and angled distal common bile duct (CBD) (\< 1350)
* Diagnostic ERCP with successful CBD deep cannulation and temporarily CBD stenting
* No history of cholecystectomy
* General condition fit for GA

Exclusion Criteria:

* History of recurrent pyogenic cholangitis
* Failed endoscopic biliary stenting by initial ERCP
* Complications of ERCP (severe necrotizing pancreatitis, papillotomy bleeding or bowel perforation)
* Previous upper abdominal surgery, including gastrectomy
* General condition unfit for GA

Where this trial is running

Hong Kong

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions CholedocholithiasisDifficultRoboticEndo-laparoscopicRandomizedTrial
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.